State Lowers OHP Barriers for Transgender Oregonians

Oregon’s Health Evidence Review Commission (HERC) reduced barriers and expanded coverage to Oregon Health Plan (Medicaid) for transgender Oregonians by moving closer to treating the health care needs of transgender Oregonians the same as any other health care service.

To access basic care for gender dysphoria, the Commission adopted guidelines from the World Professional Association for Transgender Health (WPATH), which allows a number of health and mental health providers to diagnose a transgender person with gender dysphoria and make a referral for care.

Additionally, the HERC reduced the number of referral letters needed for chest and breast surgeries of any kind to one, and clarified and codified billing codes for surgeries that previously lacked any kind of designation. The Commission also maintained medically appropriate health care coverage for transgender youth.

These actions make it easier for transgender Oregonians experiencing gender dysphoria to begin treatment, thus bringing the state’s Medicaid system closer to treating all Oregonians with dignity and fairness.

“Every week we receive calls from transgender Oregonians being denied care,” said Nancy Haque, Co-Director. “These changes are important steps in treating transgender Oregonians like other Oregonians. Ultimately, our entire health system must change in order for transgender Oregonians to access lifesaving health care the way other Oregonians do so they no longer have to endure invasive assessments, outdated evaluation protocols and discrimination.”

Basic Rights Oregon, TransActive Gender Center and other groups advocated for reducing these barriers, submitting more than 40 letters from teens, parents, adults and health care providers and advocates throughout Oregon. Oregon now joins California, Vermont, Massachusetts, Washington and Washington D.C. in including coverage for gender dysphoria services in Medicaid programs.

Transgender Oregonians face disproportionate barriers to accessing critical healthcare needs simply because of who they are. The 2011 National Transgender Discrimination Survey reports that transgender Oregonians are four times as likely to live in poverty, and that 41 percent of trans-identified Oregonians have reported attempting suicide. Discrimination puts transgender people and their families at risk for serious health problems and financial hardship.